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This EoI Form contains Profile Sections(A-C) and a separate Application Section (D) for this At-Large Board Member Selection cycle. Please use the <Edit Contents> menu option (above) to complete all form sections and always remember to <Save> your page (see the button at the bottom right) (Note: We recommend that you NOT click the <Save Draft> button because its operation is not intuitive, you may lose your work). If you are unable to complete the entire form in one session, you may return multiple times to complete it using <Edit Contents> and <Save> when finished. To indicate to the Program Admin Staff that you are finished working with the EoI Form, please complete the "Consent and Authorization" area at the bottom and click <Save>. As soon as realistically possible, Program Admin Staff will validate your final submission for completeness and subsequently restrict it from further editing The right column contains data fields which are either free-form text, drop-down selection menus, or numeric. For certain text fields, clicking your mouse in the cell will bring up an Editor offering an extensive menu at the top containing formatting options including: headings, fonts, bullets, paragraph indentation, links, tables, and an insert menu offering even more capabilities (e.g., images, attachments). As a precautionary measure, there are very few embedded links in this EoI Form to prevent being transported out and potentially losing your work. External materials that can be referenced are marked in orange bold text. If you need to consult any of these documents, be sure to <Save> your active page (see the button at the bottom right of this Form) and return to it when convenient. If you are comfortable working in multiple tabs/windows and want to visit any external source while working in this document, be sure to <Right-Click> the link using your mouse (or pointing device) to open it in another tab/window. For your convenience, all documents and materials referenced in this year's application process are contained on these pages:
If you have any questions about this process, please send an email to the Program Admin Staff. IMPORTANT:
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Section B: Qualifications & Professional Background
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1) Please describe any current and past volunteer positions, roles, and accomplishments. The Committee is particularly interested in Board or similar directorship experience. Please include the name and web page of such organizations, if applicable. |
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2a) Have you held or do you currently hold a Board or executive management position in any organization? |
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2b) If "Yes," please state the nature and size of the organization(s) in which you currently hold or have held a Board or executive management position. |
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3a) Do you have experience working with non-profit organizations? |
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3b) If "Yes," please state the nature and size of any non-profit organization(s) including any Board positions or executive committees upon which you currently serve or have served. |
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4) Briefly describe any experience you have had working with groups in various locations and time zones around the globe. |
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5) Being able to read and to express yourself publicly in English is mandatory for leadership positions at ICANN. Do you meet this criterion? |
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6) Which other languages do you speak and at what level of fluency?
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1) Describe your current and past involvement in, contributions to, and leadership roles in activities and organizations involved in the development and operation of the Internet, its naming and addressing infrastructure, and/or its security and stability.
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2) Conflicts of Interest
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3) Please explain any positions you hold as Director, major shareholder, or employee of a Generic Top Level Domain (gTLD) Registrar or Registry, Country Code Top Level Domain (ccTLD) Registry or a Regional Internet Registry (RIR). |
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Section D: Application for At-Large Board Member Position | |||||||||||||||||
1) Please state your opinion about what would be your unique expertise or perspective and what added value you might contribute to the ICANN Board: |
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2) Please describe how and why you meet the criteria for this position:
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3) Please state what you would contribute in the At-Large selected ICANN Board Member Position to the At-Large Community |
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4) Please describe specifically how and why you will be able to advance, at the ICANN Board, the interests of the At-Large Community and the broader global community of Internet end-users. |
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5) Time Commitment:
Are you able to commit this amount of time for this position? |
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6) Please describe your understanding of changes to ICANN's Bylaws, organizational structure, and accountability mechanisms that have been put in place as part of the transition of the stewardship of IANA functions. Please also describe any personal involvement you have had in these changes. |
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Consent and Authorization: |
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Dear Candidate: The statements below seek your consent and authorization for actions that may be taken by the At-Large Board Candidate Evaluation Committee (BCEC) in its consideration of your Expression of Interest (EoI). You acknowledge and/or authorize that:
When you have finished completing all of the applicable information contained in this EoI Form (Sections A to D), please indicate your understanding of and agreement to this Consent and Authorization and that you seek to become a Candidate under the conditions described above. Please select "Yes - Agree and Submit", complete the date field below, and click <Save> (see the button at the bottom right) to signify that:
(Note: All forms will be closed to further editing effective 23:59 UTC on Friday, 18 November 2016).
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At-Large Board Candidate Application Template v1 (Oct 2016)